Understanding and Coding MDS 3.0 Item K0520A2: Nutritional Approaches - Parenteral/IV Feeding, Not a Resident

Understanding and Coding MDS 3.0 Item K0520A2: Nutritional Approaches – Parenteral/IV Feeding, Not a Resident

Introduction

Purpose:
MDS Item K0520A2, Nutritional Approaches – Parenteral/IV Feeding, Not a Resident, documents whether an individual who is not classified as a resident of the facility received parenteral or intravenous (IV) feeding. Parenteral/IV feeding is essential for individuals who cannot absorb nutrients through the gastrointestinal tract. Correctly coding this item ensures the accurate documentation of nutritional support provided to individuals who may receive care at the facility but are not formal residents. This article explains how to code MDS Item K0520A2 according to the MDS 3.0 guidelines.

What is MDS Item K0520A2?

Explanation:
MDS Item K0520A2 refers to individuals who are not residents but received parenteral or IV feeding during their interaction with the facility. Parenteral/IV feeding involves delivering nutrition directly into the bloodstream for individuals unable to use their gastrointestinal tract. It includes:

• Total Parenteral Nutrition (TPN),
• Peripheral Parenteral Nutrition (PPN).

This item helps document the care provided to non-residents who require nutritional support through parenteral or IV feeding during temporary care, such as outpatient visits or short-term evaluations.

Guidelines for Coding K0520A2

Coding Instructions:
To accurately code Item K0520A2, follow these steps:

1. Confirm the Individual’s Residency Status:

   • Ensure the individual is not a resident of the facility. This item applies to those receiving temporary care or evaluations without being formally admitted as a resident.

2. Review Medical Records for Parenteral/IV Feeding Use:

   • Check the individual’s medical records or treatment plan to confirm whether parenteral or IV feeding was administered during their time at the facility.

3. Code Based on Parenteral/IV Feeding Use:

   • Code “1” for Parenteral/IV Feeding – Not a Resident if the individual was receiving parenteral or IV nutrition during their interaction with the facility.
   • If the individual was not receiving parenteral/IV feeding, leave this item unmarked and code the appropriate nutritional approach.

4. Enter the Response in Item K0520A2:

   • If parenteral or IV feeding was used, enter “1” in K0520A2.

Example Scenario 1:
A patient receiving outpatient care at the facility is placed on Total Parenteral Nutrition (TPN) due to gastrointestinal failure. In this case, “1” would be entered in Item K0520A2 to reflect that parenteral feeding was provided to a non-resident.

Example Scenario 2:
An individual undergoing temporary evaluation at the facility was on Peripheral Parenteral Nutrition (PPN) due to short-term digestive issues. In this case, “1” would be entered in K0520A2 to document parenteral/IV feeding for the non-resident.

Best Practices for Accurate Coding

Documentation:

• Ensure the individual’s medical records clearly document the use of parenteral/IV feeding during their time at the facility, even though they are not classified as a resident.
• Include detailed notes on the type of feeding, the regimen followed, and the medical condition that required parenteral nutrition.

Communication:

• Provide clear documentation and instructions to the individual’s caregivers or healthcare providers to ensure the continuation of parenteral/IV feeding if necessary.
• Communicate the importance of monitoring for complications, such as infections or metabolic issues, related to parenteral feeding.

Monitoring and Follow-Up:

• If parenteral or IV feeding is to continue after the individual leaves the facility, ensure proper follow-up is arranged with a healthcare provider.
• Educate caregivers or family members on how to manage the feeding regimen at home and recognize potential issues that may require medical attention.

Conclusion

Summary:
MDS Item K0520A2 is used to document the use of parenteral or IV feeding for individuals who are not classified as residents of the facility. Proper coding of this item ensures that nutritional interventions are accurately tracked for non-resident individuals who may require care at the facility. By following the guidelines and best practices outlined in this article, healthcare professionals can ensure proper documentation and care planning for individuals receiving parenteral/IV feeding during their time at the facility.

Click here to see a detailed step-by-step on how to complete this item set

Reference

CMS's Long-Term Care Facility Resident Assessment Instrument 3.0 User’s Manual, Version 1.19.1, October 2024. Refer to [Chapter 3, Page 3-184] for detailed guidelines on coding parenteral/IV feeding use for non-residents.

Disclaimer

Please note that the information provided in this guide for MDS 3.0 Item K0520A2: Nutritional Approaches – Parenteral/IV Feeding, Not a Resident was originally based on the CMS's Long-Term Care Facility Resident Assessment Instrument 3.0 User’s Manual, Version 1.19.1, October 2024. Every effort will be made to update it to the most current version. The MDS 3.0 Manual is typically updated every October. If there are no changes to the Item Set, there will be no changes to this guide. This guidance is intended to assist healthcare professionals, particularly new nurses or MDS coordinators, in understanding and applying the correct coding procedures for this specific item within MDS 3.0. The guide is not a substitute for professional judgment or the facility’s policies. It is crucial to stay updated with any changes or updates in the MDS 3.0 manual or relevant CMS regulations. The guide does not cover all potential scenarios and should not be used as a sole resource for MDS 3.0 coding. Additionally, this guide refrains from handling personal patient data and does not provide medical or legal advice. Users are responsible for ensuring compliance with all applicable laws and regulations in their respective practices.